Dataset Information

Validity and utility of ICD-10 administrative health data for identifying ST- and non-ST-elevation myocardial infarction based on physician chart review.

ABSTRACT:

Background

Health care administrative databases are useful for assessing the population-level burden of disease and examining issues related to access, costs and quality of care. In these databases, the diagnoses and procedures are coded with the use of the World Health Organization International Classification of Diseases (ICD). We examined the validity of 2 ICD-10 coding definitions for categorizing patients with acute myocardial infarction (MI) as having ST-elevation MI (STEMI) or non-ST-elevation MI (non-STEMI).

Methods

Charts of patients with acute MI discharged between April and June 2007 from 3 hospitals in Edmonton, were reviewed to define the acute MI subtype (i.e., STEMI v. non-STEMI). The agreement between clinician chart review and STEMI/non-STEMI classification based on the standard (ICD-10 I21.x) and the supplementary electrocardiogram (ECG) codes (R94.3x) was determined. We assessed the effect of these alternative definitions on in-hospital mortality estimates by applying them to the data for all patients with acute MI admitted to hospital in the province from April 2007 to March 2010.

Results

Of the 297 patients, 49.2% were identified as having STEMI based on chart review, 44.4% using the standard definition, and 44.1% using the ECG definition. Both the standard and ECG definitions provided high agreement (92% for STEMI and 100% for non-STEMI) with the chart review classification. In the larger population-level cohort (n = 15?148), use of the standard definition or the ECG definition did not affect in-hospital mortality estimates for patients with STEMI and those with non-STEMI.

Interpretation

The standard definition appears equivalent to the definition using supplementary ECG codes to subcategorize patients with acute MI as having STEMI or non-STEMI. These findings may be relevant for the development of later versions of ICD codes.

SUBMITTER: Patel AB

PROVIDER: S-EPMC4987155 | biostudies-literature | 2015 Oct-Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Validity and utility of ICD-10 administrative health data for identifying ST- and non-ST-elevation myocardial infarction based on physician chart review.

Patel Alka B AB Quan Hude H Welsh Robert C RC Deckert-Sookram Jessica J Tymchak Wayne W Sookram Sunil S Surdhar Ian I Kaul Padma P

CMAJ open 20151002 4

<h4>Background</h4>Health care administrative databases are useful for assessing the population-level burden of disease and examining issues related to access, costs and quality of care. In these databases, the diagnoses and procedures are coded with the use of the World Health Organization International Classification of Diseases (ICD). We examined the validity of 2 ICD-10 coding definitions for categorizing patients with acute myocardial infarction (MI) as having ST-elevation MI (STEMI) or non ...[more]

PMID: 27570759

Similar Datasets

Project description:Importance: S100A12 is a calcium binding protein which is involved in inflammation and progression of atherosclerosis. Objective: We sought to investigate the utility of S100A12 as a biomarker for the early diagnosis and prognostication of patients presenting with ST-segment elevation myocardial infarction (STEMI). Design, Setting, and Participants: S100A12 was measured in 1023 patients presenting to the emergency department with acute chest pain between June 2012 and November 2015. An independent cohort of 398 patients enrolled at 3 different hospitals served as a validation cohort. Main Outcomes and Measures: The primary clinical endpoint of interest was major adverse cardiac and cerebral events (MACCE) defined as a composite of all-cause death, MI, stroke, or hospitalization for heart failure. Results: A total of 438/1023 patients (42.8%) in the diagnosis cohort were adjudicated as STEMI, among whom plasma S100A12 levels increased within 30 min and peaked 1-2 h after symptom onset. Compared with high-sensitivity cardiac troponin T and creatine kinase-MB isoenzyme, S100A12 more accurately identified STEMI, especially within the first 2 h after symptom onset (area under the curve 0.963 compared with 0.860 for hscTnT and 0.711 for CK-MB, both P < 0.05). These results were consistent in the 243-patient validation cohort. The 1-year rate of MACCE was greatest in patients in the highest peak S100A12 tertile, intermediate in the middle tertile and least in the lowest tertile (9.3 vs. 5.7 vs. 3.0% respectively, Ptrend = 0.0006). By multivariable analysis the peak plasma concentration of S100A12 was an independent predictor of MACCE within 1 year after STEMI (HR, 1.001, 95%CI, 1.000-1.002; P = 0.0104). Conclusions and Relevance: S100A12 rapidly identified patients with STEMI, more accurately than other cardiac biomarkers, especially within the first 2 h after symptom onset. The peak plasma S100A12 level was a strong predictor of 1-year prognosis after STEMI.

Dataset Information

Validity and utility of ICD-10 administrative health data for identifying ST- and non-ST-elevation myocardial infarction based on physician chart review.

Background

Methods

Results

Interpretation

Publications

Validity and utility of ICD-10 administrative health data for identifying ST- and non-ST-elevation myocardial infarction based on physician chart review.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets